Dead Bodies for the Masses:
The British Public Autopsy & The Aftermath
During the last year, a considerable amount of discussion has arisen from the work of Prof. Gunter von Hagens, famed for his exhibition Body Worlds , which has been publicised extensively and displays 'real' human bodies in an artistic, though anatomically graphic form. The exhibit has been touring around the world for some time and is currently showing at a back-street location in Brick Lane, London, UK, where visitors are flocking in the thousands. The display is a tribute to and celebration of von Hagens' method of preserving organic life through the process of plastination, developed by him in the 1980s. The process entails a form of preservation, whereby body parts are dehydrated and filled with polymer resin, making them more robust than does conventional formaldehyde. The bodies have a clear appearance of being real, both in colour and texture.
Despite the vast popularity of the exhibition, the reasons for attributing its success are open to interpretation. The imaginative would have that von Hagens' work has artistic merit as an exhibition. (It is, after all, presented in a gallery.) Sceptics and moralists would claim that viewers are being brought to the gallery by the immense publicity and that visitors attend the exhibit due mainly to a fascination with the extraordinary, the grotesque, or simply the spectacle.
However, the controversy arising from the exhibit pales in comparison to von Hagens' most recent performance, a 'public autopsy'; the first in Britain for nearly 200 years. The autopsy took place on the evening of 20 November 2002, in front of a randomly selected (but paying) audience. Later that same night, terrestrial Channel 4 broadcast an edited version of the event in the UK, after having made headline evening news on both BBC1 and ITV .
All discussions concerning the autopsy have been controversial. Commentators have been preoccupied with the ethical issues surrounding the use of a human corpse in what appears to have been, for many, simply a public spectacle. Yet, this ethical discussion has been at the expense of more complex, cultural, artistic, moral discourses, which have been conflated in the public analyses.
Certainly, one can acknowledge the relevance of a medical ethics discourse surrounding this event, largely because it has been categorised as a medical procedure (and because there are laws governing the use of cadavers). From this perspective, there has been a concern for human dignity, given that the conditions of the autopsy -- an operating 'theatre' -- for some, seemed to trivialise the value of the corpse being dissected (even though the anonymous individual's family had given consent for his body to be used for educational purposes).
Additionally, during Channel 4's broadcast of the autopsy and the subsequent debates, opinions were sought mainly from medical experts. From the perspective of Channel 4 producers, the 'scoop' was evidently the controversial moral discussion raised by the public nature of the autopsy. Partly, this was about the 'public' component; partly, it was due to the performative nature of the event. As well, there was a slight (but not insurmountable or particularly interesting) legal issue, as von Hagens did not have a UK license to perform the procedure. This small matter was significantly underplayed throughout the broadcast and officials decided to allow it to take place (although, the legal case against von Hagens is ongoing). Regardless, the underlying moral issue about the public autopsy was that these components of being 'public' and 'performative' diminished the value of the cadaver who was being dissected before a television audience.
Despite these moral worries, one fundamental and straightforward difficulty about the discussion surrounding the autopsy was that probably the least useful opinions to have been sought were from the medical community, if the hope was to capture the innovative and profound aspects of this event. Indeed, it would seem that medical experts are themselves part of the context of critique to which the von Hagens discourse seemed to be directed. After all, supporters of the autopsy and the exhibition believe that it has merit and value because it forces on-lookers to confront their relationship with medicine and to re-appraise the comfort and relative safety of a 21st century life in Western societies.
Moreover, even if medical ethicists concluded that the performative element of von Hagens' work were inappropriate, this was not only for medical ethicists or bioethicists to discuss. The day after the autopsy (21 November) in the British Medical Journal, Dr. Richard Bryan gave a 'rapid response' indicating his disapproval of Channel 4's broadcast of the Autopsy . Referring to Andreas Vesalius, the 16th Century anatomist, Bryan mistakenly assumes that there are direct and clear comparisons to be made by virtue of von Hagens' autopsy being public. Yet, one cannot make such straightforward analogies, even if von Hagens referred to his ancestors as a justification for wearing his trademark black hat throughout the procedure (or, as von Hagens called it, his 'performance').
Whether or not von Hagens' performance was educational is not really the critical issue or the most valued attribute of the autopsy. As such, it ought not to have been the sole basis upon which it was evaluated. On the criteria Bryan sets himself for his evaluation of the Hagens autopsy, his claims are accurate. Moreover, they are in accordance with the British Medical Association's Dr. Michael Wilks and Emeritus Professor of Surgery Harold Ellis, who were both providing a commentary for Channel 4 viewers during the broadcast. Each of them was equally displeased with the performance and it is precisely because these reactions were predictable that they were both completely useless to help understand its significance. It was valuable, I suggest, neither for its educative function nor for it being entertaining -- the preferred moral dichotomy of Channel 4's broadcast.
Appreciating the significance of the event requires a strong sensitivity to the sociological understanding of medicine and a broad philosophical appreciation for the critique that society has become far too sanitised or clinical and that people no longer engage with the messiness of being human. The autopsy had the potential to re-describe being human in a manner that lends greater insight into contemporary, western society and even the role of medicine, which is often cloaked by institutional bureaucracy. Such an appreciation for the autopsy can reveal more about the relationship between humans, their bodies, and, ironically, the manner in which medical ethics serves to distance patients from their conditions.
The transformation of the body, literally, inside-out by von Hagens provided a means for re-engaging with our subdued curiosity about identifying what is grotesque about being human or for relinquishing the burden of 'skin' and 'proportion' as the basis for attributing value to persons (as normalness). In this form, the dead body represents the culmination of fascination for the Other. It is one step further from initiatives such as the Visible Human Project , which purports to have been primarily for medical practitioners. It does not seem coincidental that the VHP was also used as the basis for a gallery exhibit . However, in contrast, the public autopsy purported to being for the people, both a literal gallery and the best of reality-TV.
A further basis for critique is the way in which Channel 4 broadcast the autopsy, itself rich with revealing choices about the preparedness of viewers to witness the grotesque and role of media(tion) within the United Kingdom. At many times throughout the broadcast, viewers could see very clearly that Channel 4 cameras were shooting particularly graphic aspects of the cadaver, but were not broadcasting them, thus heightening the viewers' curiosity and anticipation.
Looking again at Bryan's 'medical' response, it fails to distinguish between Channel 4's edited broadcast and the autopsy itself. Rather typically, no criticism or in-depth inquiry concerns Channel 4's edit, though the stronger reasons for condemning the autopsy would seem most justifiable in relation to the broadcast rather than the autopsy itself. Channel 4 programmed the viewing at 11:45pm (tens of minutes after the autopsy actually finished), took substantial shortcuts in the presentation of the event, giving the impression of it being incredibly rushed, and omitted to view certain images, perhaps to the pleasure of some people. There seemed much more of an interest from Channel 4 to shoot the reactions on the faces of the audience, rather than to engage the viewer with what was taking place, thus strengthening the criticism that the autopsy was nothing more than a spectacle.
Bryan also reacts to the comment made by Christine Odone, Deputy Editor of New Statesman, the long-standing, high-brow UK political magazine, that there was a 'whiff of death' in the process. Odone was arguing that the procedure allowed the audience to come closer to death and that this provided a rich and important experience. However, Bryan's response was that one would only have smelled formalin from such a corpse, thus ridiculising Odone's reaction. Bryan's response simplifies the autopsy considerably. Interpreting Odone's comment in a manner of being ridiculous sensationalism misconstrues the context of such a comment.
Another occurrence during the autopsy, which strengthens this idea, was the moment when von Hagens lifted the internal organs out of the cadaver and placed them next to the body, at which point the audience erupted into a spontaneous, if somewhat reticent applause. This difficult moment seemed to reinforce the performative nature of this event, but speaks more to the awkwardness of the audience than to the sensationalistic manner in which it was being carried out. What else can one do in an audience when witnessing something extraordinary and unknown? Applause is the only resource an audience has to demonstrate its reaction.
One might question what has been gained from this performance. From the medical perspective, perhaps the most useful lesson of the autopsy is that, for far too long, medicine has been outside of the public domain and that this has stifled the understanding and acceptance of new medical procedures. For this reason alone, there is merit in the positive discourse surrounding von Hagens' works, even if his delivery remained weak. Of utmost importance is for medical practitioners to recognise the public autopsy was an opportunity for re-addressing the relationship between the medical community and its prospective patients.
Yet, this alone does not reveal why the public autopsy gained such notoriety and attention. There is an underlying premise to a public autopsy in the UK that is highly appealing and intellectually rich, even if the process through which it has been delivered in the exhibit and by the autopsy were ineffective. An exploration of death through art deserves greater attention, particularly when it offers a rare and needed philosophical insight into contemporary medicine. Yet, von Hagens is not the first 'artist' to raise questions about the meaning of death through artistic endeavours.
One of the disappointments of the Body Worlds exhibit and the public autopsy is that they not seem indicative of anything particularly complex about death, the body, or anything quite so complex. Von Hagens' autopsy did appear to be performative and self-congratulatory and there did not seem willingness from the artist to explore the more conceptual elements of a public autopsy (perhaps for fear of even greater attack from the medical community). Von Hagens' exhibits and his autopsy were comparable to a 19th century freak show. People are paying, not to engage with broad philosophical concepts about being human; nor do they depart from a premise that modern humans no longer engage with the grotesqueness of life. This is unfortunate mostly because it could have been otherwise. The reason for why these events have attracted such attention is precisely because people feel that there is such a need. There is a philosophically credible rationale for von Hagens' work and one can make a reasonable case for wanting to drag medicine out into the public domain.
The equivocation about whether von Hagens' public autopsy was a performance or a procedure; why people applauded at seeing the cadaver's internal organs lifted out of the body; why the event was allowed to take place despite von Hagens not having a licence; why the Body Worlds exhibition has generated so much interest, and why this at all has attracted Channel 4 to broadcast it and other major television channels to place it in their headlines, is precisely because there is a general, social equivocation about medicine. Each of these elements has been interesting largely for the non-medical practitioner -- the potential and actual patients or, perhaps, consumers of medicine.
One of the main questions to conclude the autopsy was whether it should happen again. Such an approach to this topic misunderstands the intention, which is to problematise the autonomy of ethics as a leading discourse in what is medically sound. Degradation and humiliation were (and are) the concerns of the medical ethicist -- a concern for the evasive, but intuitive concept 'human dignity', the bedrock of medical ethics. The art of medical ethics has been the preservation of the abstract (of this particular abstract), of keeping medicine enclosed. Both the autopsy and the exhibit are pursued by von Hagens in the name of 'art' and 'education'; yet they fail to deliver either. Instead, they borrow from the appealing notion of having revealed something -- von Hagens' autopsy was comparable to the magician pulling a rabbit out of a hat -- claiming to force a confrontation with the profound; with life and death. In this sense, it strikes a chord with contemporary critiques of the public-private distinction  and the function of curiosity in moral reasoning .
Yet, von Hagens' exhibits are broken-bodies, trivial-bodies -- they are placed into the positions of pole-vaulters and basketball players. There is even a winged man, whose latissimus dorsi muscles are spread out behind him. He is neither ordinarily human nor monstrously grotesque; but is comical. It neither demystifies humanness, nor inspires feelings of horror. It is not banal; but neither is it at all profound. The exhibition and the autopsy were a tragedy, an allusion to what could have been. But, it made good television.
 Body Worlds Website: http://www.bodyworlds.com
 Information and comments from the public about the Autopsy can be found at the Channel 4 website, particularly Channel 4's 'Think TV' section at, http://www.channel4.com/culture/microsites/T/thinktv/comments/nov_autopsy_comments_2.html
 Bryan, R.T. "Rapid Response: The Autopsy, Channel 4, 20th November 2002," British Medical Journal (2002, Nov 21)
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Andy Miah is Lecturer in Media, Bioethics, and Cyberculture at University of Paisley, Scotland and Tutor in Ethics of Science & Medicine in the Graduate School of Biomedical & Life Sciences, University of Glasgow, Scotland. He is co-editor of a special book edition of the journal Research in Philosophy and Technology (Elsevier Science, 2002) and author of the forthcoming Routledge publication Genetically Modified Athletes: Biomedical Ethics, Genes & Sport (expected 2003). In relation to this monograph, he was an International Visiting Scholar (2002) of The Hastings Center, New York. http://www.andymiah.net